[Comparative characterization of walking biomechanical parameters in hip prosthesis users with mechanical and electronic knee modules]. / Sravnitel'naya kharakteristika biomekhanicheskikh parametrov khod'by u pol'zovatelei protezov bedra s mekhanicheskim i elektronnym kolennymi modulyami.

According to many studies, prostheses with electronic knee modules have some important technical advantages over mechanical knee modules, allowing the user to have a more active lifestyle and significantly improving the overall quality of life. However, we have found no published Russian studies of the biomechanics of walking on such prostheses for more than 20 years of their use in Russia. OBJECTIVE: To compare spatial and temporal parameters of walking in patients after hip replacement using prostheses with electronic and mechanical knee modules. MATERIALS AND METHODS: The study included 94 patients aged between 18 and 50 with hip prostheses. The patients were divided into two groups: Group 1 included 48 patients with a hip prosthesis with a mechanical knee module; Group 2 included 46 patients with a hip prosthesis with an electronic knee module. The groups were comparable in size, gender and age distribution, and mobility grade (grade 3 according to the MOBIS classification system). All patients had no comorbidities or injuries that could limit mobility. Spatial and temporal parameters of walking on hip prostheses with different knee modules were assessed using a video analysis system (SMART DX5000, Italy). RESULTS: Group 2 patients (prostheses with electronic knee modules) had the following spatial and temporal biomechanical walking indices: arbitrary walking speed 1.10-1.08 m/s, walking pace 105.82 steps/minute, step cycle 1.13-1.15 s, double step length 1.27 m, rhythm index 0.89. Group 1 patients (prostheses with mechanical knee modules) had worse outcomes according to the same indices: walking speed 0.81-0.87 m/s, walking pace 90.84 steps/minute, step cycle 1.33 s, double step length 1.07 m, rhythm index 0.74. Preferred walking speed and walking pace indices in patients with electronic knee modules in hip prostheses were at the lower limits of reference values in healthy individuals; the step length was insignificantly reduced; the rhythm index was close to that of healthy individuals (0.94-0.97). CONCLUSION: The results of the study show that the use of prostheses with electronic knee modules in patients with amputation at the hip level enables patients to learn better symmetrical walking and significantly increases their mobility compared to mechanical modules.

[Aerobic exercise and fatigue indices in rheumatoid arthritis patients in the health resort care setting]. / Aerobnye uprazhneniya i pokazateli ustalosti u bol'nykh revmatoidnym artritom v usloviyakh sanatorno-kurortnogo lecheniya.

Fatigue is one of the most common symptoms of rheumatoid arthritis (RA). There is strong evidence that physical activity is an effective way to reduce fatigue. OBJECTIVE: To evaluate the effectiveness of aerobic exercise (walking) to reduce fatigue in RA patients in the health resort setting. MATERIAL AND METHODS: The study involved 102 female patients with RA (age 54.38±11.3 years, body mass index 20-29 kg/m2, DAS28-ESR ≤3.2, with severe fatigue of VAS ≥50) who received 21 days of health resort treatment. The health-improving and therapeutic complex includes dosed physical activity, aerobic exercises (walking). Visual analog scale (VAS0-100) and Bristol Rheumatoid Arthritis Fatigue Scale-Numerical Rating Scale (BRAF-NRS V2) were used to assess fatigue, and the 50-meter walking test was used to evaluate the functional status of patients. RESULTS: A correlation between walking duration and the number of steps at a distance of 50 m (p<0.001) as well as between these indices and fatigue (p<0.001) was shown. A positive effect of a standard three-week medical rehabilitation program for patients with RA on fatigue NRS severity (p=0.003) and NRS effect (p=0.037), as well as on patients' functional status (reduced time spent on the 50-meter test, p=0.01) was demonstrated. When comparing groups of RA patients with low (group 1, <5000-6000 steps per day) and optimal (group 2, ≥7000-8000 steps per day) aerobic exercise, positive results were noted in the short term (at 3 weeks) (p<0.001). CONCLUSION: Aerobic exercise is a promising intervention for treating fatigue in rheumatoid arthritis patients. Medical rehabilitation in a resort setting is the best starting point to encourage performing regular physical activity, as well as the best way to develop exercise programs tailored to rheumatoid arthritis patients.